[Extent of pregnancy supervision in Bavaria and measurement of its effectiveness].

Perinatal mortality is high in the Federal Republic of Germany when compared with that in the Scandinavian countries, and it is often claimed that this is due to the unsatisfactory utilisation of prenatal care examinations in this country. Good prenatal care is characterised by the fact that it starts early, that it is carried out intensively, and that it is flexibly adapted to the individual risk situation. Of 83,308 pregnant women covered 1981 by the Bavarian Perinatal Analysis Inquiry, 65.5% had consulted the doctor for the first time before the 13th week of pregnancy, whereas 1.8% consulted the doctor after the 36th week. 53.1% were examined 10 or more times. Every 8th pregnant woman (12.8%) had omitted at least two or more consultations compared with the recommendations for prenatal care and independent of the onset of the care programme. Factors exercising a positive influence on perinatal care resulted in better utilisation, and vice versa. The care programme was frequently neglected by primigravidae who where less than 16 years old, by multigravidae, unmarried mothers and foreigners. Data on the effectiveness of prenatal care are supplied by the Bavarian Perinatal Inquiry Data especially in the analysis of risk-free pregnancies. The later perinatal care was instituted, the more frequent were risk factors at birth. On the average, birth risk was seen after every 5th risk-free pregnancy (21.3%).(ABSTRACT TRUNCATED AT 250 WORDS)